Article

Objective : To compare the treatment of heterotopic ossification (HO) within the
traumatic brain and spinal cord injured populations.
METHODS: MEDLINE/Pubmed,
CINAHL, EMBASE, and PsycINFO databases were searched for articles addressing
treatment of HO post-injury. Articles were constrained to: English language and
human subjects. Studies were included if: n >/= 50% of the subjects had a spinal
cord injury (SCI) or a traumatic brain injury (TBI), n >/= 3 SCI or TBI subjects,
and study subjects participated in a treatment or intervention. Study quality,
for randomized control trials (RCTs), were assessed using the PEDro assessment
scale, while non-RCTs was assessed using the Downs and Black evaluation tool. A
modified Sackett scale was used to apply levels of evidence for each
intervention. RESULTS: In total 26 studies (NTBI = 12; NSCI = 14) met inclusion
criteria. The majority of studies (10/12) conducted in the TBI population were
surgical interventions. Studies conducted with the SCI population investigated
diverse pharmacological treatments including : bisphosphonates, non-steroidal
anti-inflammatory drugs (NSAIDs) and Warfarin. Non-pharmacological studies
investigated the benefits of pulse low-intensity electromagnetic field therapy,
surgical excision, and radiotherapy in the treatment of HO. CONCLUSIONS: Within
the SCI literature, NSAIDs showed the greatest efficacy in the prevention of HO
when administered early after a SCI, and biphosphonates were found to be the most
effective treatment strategy.
In the TBI population, surgical excision was the
most effective treatment.

Langue : ANGLAIS